Breast Milk Bought Online May Contain Harmful Germs: Study

MONDAY, Oct. 21 (HealthDay News) -- Even after working with
several nursing experts, first-time mom Katie Sweet wasn't able to
make enough of her own breast milk to feed her newborn
daughter.

And she said her baby just didn't do well on formula.

"Honestly, my daughter is a completely different girl on breast milk. She has less stomach issues, she sleeps better and seems more alert," said Sweet, an insurance agent in Grand Junction, Colo.

For a few months, she was able to keep her daughter on a
breast-milk diet with the help of two local friends who were making
more milk than they needed. But when those women weaned their own
infants, her supply ran out, leaving her desperate to find
more.

"I would do anything to make sure she got what she needed to be happy," Sweet said.

Like growing numbers of women who've gotten the message that
breast milk is the best possible food for babies, but who find
themselves unable to supply their own, she turned to the
Internet.

She placed a classified ad offering to buy breast milk from a
stranger on a website set up to connect people who want to sell
their breast milk with others looking to purchase it.

"My husband and I did a lot of research and felt comfortable with the decision to purchase milk," Sweet said.

Her comfort turned to concern, however, as she learned of the
findings of a new study that tested raw breast milk bought through
the Internet.

The researchers did not name the specific websites used in their
study but said the contaminated samples came from a U.S.
milk-sharing website that uses a classified ad format.

Of 101 samples purchased anonymously, nearly three-quarters of
the samples contained bacteria that could make a baby sick,
including three batches that tested positive for salmonella.

"There should not be salmonella in human milk," said Dr. Kathleen Marinelli, chair of the United States Breastfeeding Committee, a nonprofit group based in Washington, D.C.

Salmonella and other kinds of gram-negative bacteria, which were
the most common types found in the study, normally live in a
person's gut.

"That tells me that the person who pumped that milk used very bad hygiene. Essentially, they didn't wash their hands after using the toilet," said Marinelli, who was not involved in the study.

None of the samples tested positive for HIV (the AIDS virus),
which can be passed through breast milk. But one in five tested
positive for another virus called cytomegalovirus, or CMV.

CMV is common -- somewhere between 50 percent and 80 percent of
people have had CMV by the time they're 40, according to the U.S.
Centers for Disease Control and Prevention.

In healthy babies, CMV causes a mild flu-like illness that's
rarely serious, Marinelli said. But for premature infants and those
with compromised immune function, the virus can be very
dangerous.

"If preemies get milk with CMV in it, they can get everything from a systemic illness that can put them back on a ventilator and make them really, really sick, to death, so you don't want them to get milk with CMV in it," said Marinelli, who is also a neonatologist at Connecticut Children's Medical Center, in Hartford.

Intriguingly, when the researchers compared the contamination in
the purchased breast milk to unpasteurized samples that had been
donated to a local breast milk bank, they found the donated samples
were less likely to contain harmful germs.

Researchers say there may be a couple of reasons for the
differences. The first is that milk banks carefully educate donors
about safe collection and handling of breast milk. Some websites
also post safe-sharing guidelines, but buyers have no way to know
whether sellers are actually following them.

And previous studies have found that almost one in three mothers
never cleans her breast pump.

"What this experience has taught us is that when you open the box of milk that you've bought, there's really nothing that can reassure you that the milk is safe," said study researcher Sarah Keim, principal investigator in the Center for Biobehavioral Health at Nationwide Children's Hospital in Columbus, Ohio.

Keim said the researchers logged all sorts of information about
the milk they got to find patterns of problems that might signal
contamination. Some of the milk was shipped with gel packs or dry
ice to keep it cold, but that didn't seem to matter. The
temperature of the milk when it reached the researchers didn't make
a difference. The kind of container and its condition also didn't
seem to play a role, nor did promises of healthy, fresh, or organic
milk in ads placed by sellers.

"There was nothing that was helpful," Keim said. "You just don't know what you're getting."

In addition to bacteria and viruses, milk can contain traces of
drugs and other environmental contaminates, like cigarette
smoke.

Profit may also have a hand in how safe the milk is. In the
1950s, when blood banks paid people for blood and plasma, studies
found that purchased samples were seven to 10 times more likely to
carry diseases like hepatitis than donated samples. The theory was
that people who needed to sell blood to make money were also less
likely to be healthy than those who donated to patients.

"With the monetary piece in this, we're a little worried that people might be incentivized to do things that aren't 100 percent honest and safe," Keim said.

She also said they're in the process of retesting their samples
to find out exactly what's in them "because we suspect some of them
might not have been 100 percent human milk."

The study is published online Oct. 21 and in the November print
issue of
Pediatrics.

Milk-sharing advocates point out that women have been helping
each other nurse for generations. Before the Internet came into the
picture, they say, mothers often relied on other women as wet
nurses. And they say there's never been a documented case of a baby
getting sick from shared milk.

That's true, Marinelli said, adding, "But do you think a mom who
is buying milk off the Internet and her kid gets sick is going to
necessarily tell the doctors what she did?"

And she said that most of the kinds of bacteria found in the
study would probably cause symptoms like diarrhea, vomiting,
listlessness, and in severe cases maybe an all-over infection --
and mothers might not even realize that the milk caused the
problem.

For her part, Katie Sweet, who said she was still waiting for
the first shipment of purchased breast milk to arrive, said the
study left her feeling disappointed. She said she planned to
contact her doctor and a friend who is a nurse practitioner to
figure out how to proceed.

"I think if you work so hard to seek out milk it would be devastating to have a reaction like that," she said.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.